Economic burden of gastrointestinal malignancy among Medicare beneficiaries: A real-world cost-of-illness study

Over two-thirds of gastrointestinal (GI) malignancies occur in adults aged 65 and older, yet limited evidence exists on the associated economic burden. This study aimed to assess healthcare costs among U.S. Medicare beneficiaries diagnosed with GI malignancies.

Using 2015-2019 Medicare Current Beneficiary Survey (MCBS) data, we conducted a pooled cross-sectional analysis of Medicare beneficiaries aged ≥65. We identified patients with GI malignancies via International Classification of Diseases (ICD) codes and compared their annual medical costs with those without GI malignancies. A two-part model adjusting for demographic, socioeconomic, and health-related factors estimated the incremental cost associated with GI malignancies.

Among 51,827 beneficiaries, 567 (1.1%) had GI malignancies. Unadjusted annual medical costs were significantly higher for those with GI malignancies ($19,582.0 vs. $7,962.4, p < 0.001). After adjustment, GI malignancies were associated with an incremental annual cost of $5,008.3 (95% CI: $2,864.7-$7,151.9) per person. Medicare covered the majority of this increase, while cost differences by gender and race/ethnicity were observed particularly in out-of-pocket, outpatient, and institutional spending.

GI malignancies place a significant economic burden on Medicare beneficiaries, driven mainly by outpatient and inpatient costs. Policy and care delivery reforms are needed to reduce costs and improve equitable access.